title: Association between sleep and breast cancer incidence among postmenopausal women in the Women's Health Initiative.
abstract: OBJECTIVE
  To determine whether the duration of sleep, sleep quality, insomnia, or sleep disturbance was associated with incident breast cancer in the Women's Health Initiative (WHI).
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Women enrolled in one of the Clinical Trial (CT) arms or the Observational Study (OS) from the WHI conducted in the United States.
  
  
  METHODS
  This study included 110,011 women age 50 to 79 years with no history of cancer.
  
  
  RESULTS
  Typical sleep duration, sleep quality, and other self-reported sleep measures over the past 4 weeks were assessed during the screening visits for both the CT and OS participants. The presence of insomnia and level of sleep disturbance was calculated from an index of the WHI Insomnia Rating Scale. The outcome for this study was primary, invasive breast cancer. A total of 5,149 incident cases of breast cancer were identified in this study. No statistically significant associations were found between sleep duration, sleep quality, insomnia, or level of sleep disturbance with the risk of breast cancer after multivariable adjustment. A positive trend was observed for increasing sleeping duration with the risk of estrogen receptor positive breast cancer, but the association estimates for each sleep duration category were weak and nonsignificant.
  
  
  CONCLUSIONS
  This study does not provide strong support for an association between self-reported sleep duration, sleep quality, insomnia, or sleep disturbance with the risk of breast cancer.
authors.affiliation: Department of Epidemiology, University of Alabama at Birmingham School of Public Health, Birmingham, AL.
authors.forename: Emily
authors.initials: E
authors.lastname: Vogtmann
authors.forename: Emily B
authors.initials: EB
authors.lastname: Levitan
authors.forename: Lauren
authors.initials: L
authors.lastname: Hale
authors.forename: James M
authors.initials: JM
authors.lastname: Shikany
authors.forename: Neomi A
authors.initials: NA
authors.lastname: Shah
authors.forename: Yohannes
authors.initials: Y
authors.lastname: Endeshaw
authors.forename: Cora E
authors.initials: CE
authors.lastname: Lewis
authors.forename: Joann E
authors.initials: JE
authors.lastname: Manson
authors.forename: Rowan T
authors.initials: RT
authors.lastname: Chlebowski
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D016016:Proportional Hazards Models; D012890:Sleep; D007319:Sleep Initiation and Maintenance Disorders / Q000150:complications; D012893:Sleep Wake Disorders / Q000150:complications
keywords: Sleep; breast cancer; insomnia; women